As the fastest growing consumer health information site a€” with 65 million monthly visitors a€” Healthlinea€™s mission is to be your most trusted ally in your pursuit of health and well-being. Clinical, pathologic, and immunopathologic features of dermatitis herpetiformis: review of the Mayo Clinic experience. However, for those with psoriasis, it means an often painful and intensely itchy chronic autoimmune disease that appears on the skin.Understand the types.
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If you have notable symptoms, your doctor or dermatologist may refer you to a rheumatologist. The rash began two weeks prior on the anterior surface of his right ankle and did not improve with a one-week course of ciprofloxacin (Cipro).

This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Apart from the skin changes and swelling of the leg, the review of systems was unremarkable.Physical examination revealed large, confluent, erythematous patches with clusters of clear and hemorrhagic vesicles, bullae, and sporadic ulcerations over the right lateral leg and anterior ankle (see accompanying figure). Direct immunofluorescence testing shows deposition of immunoglobulin G autoantibodies targeting two hemidesmosomal proteins on the basement membrane of the epidermis.1,3 Serum antibody titers for the two antigens may also be performed. Prednisone, alone or in combination with a steroid-sparing agent, is the cornerstone of treatment.
2Dermatitis herpetiformis is an autoimmune condition typified by clusters of erythematous papules, excoriations, and vesicles that arise as a consequence of gluten sensitivity.
The lesions are extremely pruritic and tend to be distributed symmetrically along extensor surfaces.2,4 Dermatitis herpetiformis is associated with celiac sprue, but it can occur with other autoimmune disorders and malignancies. Most patients are between 20 and 40 years of age, but the condition may occur at any age.2,4Erythema multiforme is an acute type IV hypersensitivity reaction to certain medications, herpes simplex virus or mycoplasma infection, and other triggers.

6 The skin lesions are usually symmetric, and there is minimal involvement of mucous membranes.
The blisters are located on the head, trunk, and intertriginous areas, and onset is typically between 40 and 60 years of age.
Pemphigus vulgaris is associated with Nikolsky sign and has a mortality rate of 5 to 15 percent.2,7 It is associated with other autoimmune diseases, including myasthenia gravis and thymoma. Blistering of the skin occurs on sun-exposed areas, especially the hands and forearms, and occasionally the face. Patients may also exhibit hypertrichosis of the forehead and cheeks, skin hyperpigmentation, and urine discoloration.

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